T(H)1/T(H)2 immune response profiles differ between atopic children in eastern and western Germany.

Abstract

Lower prevalence rates for childhood respiratory allergies have been reported in eastern Germany than in western Germany. Because allergic phenotypes are thought to be associated with an unbalanced T(H)1/T(H)2 T cell effector response, a cross-sectional investigation was carried out as part of the German ISAAC Phase II study to determine whether T(H)1/T(H)2 capacity might have developed in different directions during the separation between the 2 parts of the country. In a community-based random sample of 9- to 11-year-old (n = 6399) and 5- to 7-year-old (n = 6202) children in eastern and western Germany, the prevalence of atopy was assessed. Heparinized blood samples were collected from a subgroup of children stratified according to the number of older siblings. T(H)1 and T(H)2 cytokine productivity was determined after stimulation with phorbol ester plus ionomycin. Individuals who grew up in eastern Germany had a marked bias toward T(H)0 responsiveness (>60%), regardless of whether they were atopic. In contrast, the children of western Germany, particularly when they were atopic, showed T(H)2 polarization. This is the first epidemiologic survey to demonstrate regional differences in the T(H)1/T(H)2 response pattern and their relation to atopic disease between regions.